At the request of the VA Board of Health, I wrote a letter to the NRC in support of Virginia becoming an Agreement State.  I did this with the assurance that fees would not be higher and indeed should be lower.  This was particularly appealing to me as I have a small nuclear program.  I began my program about 11 years ago when there was instability in our local hospital program when the nuclear medicine physician left the area and the treatment by committee approach that followed left my patients dissatisfied with the care they received.  Since then I can say unequivocally that the care my patients have received has improved with fewer re-treatments being needed  and patient satisfaction has improved as they receive their nuclear treatments directed from the physician that will provides their ongoing thyroid and endocrine care.  This improved care is at no extra cost to the patient or to his insurer.

The burdensome increase in fees that has resulted from the elimination of the Small Business Entity has placed our in jeopardy by further stressing an already slim profit margin.  If small business entities are forced out of the nuclear business, quality will suffer and there will be less income to the Virginia licensing program.  I respectfully request that the Virginia program follow the example set by the NRC and restore the Small Entity fees.